Utah Administrative Code
Topic - Health
Title R414 - Integrated Healthcare
Rule R414-23 - Provider Enrollment
Section R414-23-3 - Revalidation Requirements
Current through Bulletin 2024-06, March 15, 2024
(1) An enrolled provider must revalidate with Medicaid through PRISM at intervals not to exceed five years as required by 42 CFR 424.515, depending on the provider's risk level.
(2) The Department shall notify a provider, when it is time to revalidate, with a letter mailed to the pay-to address in the PRISM system.
(3) A provider must complete and submit the revalidation process within 60 days from the date of the letter, or the Department will place a temporary payment hold on the provider account.
(4) The Department shall terminate a provider that fails to revalidate within 90 days from the date on the letter. The provider, however, has the option to request a fair hearing.
(5) A provider terminated for any reason must reenroll and be approved as a new provider.
(6) The Department may only reimburse a provider for services rendered during an enrollment period.
